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Dextromethorphan

D Methorphan


Presentation

  • We present a case of a young woman who presented to our emergency department (ED) initially diagnosed with recurrent seizures. Paramedics brought a 19-year-old woman to the ED. Witnesses noted "shaking," which the patient did not recall.[ncbi.nlm.nih.gov]
  • We report here two cases of dextromethorphan overdose that presented to the Pediatric Toxicology Service at Siriraj Hospital, Bangkok, Thailand. Both cases presented with hyper-agitation, confusion, with signs of sympathomimetic overdose.[ncbi.nlm.nih.gov]
  • In summary, the present data suggest that glutamatergic neurotransmission across the NMDAR is only one among many determinants of intact visual perception.[ncbi.nlm.nih.gov]
  • A patient presented with agitation, paranoia, and psychosis following ingestion of dextromethorphan, propoxyphene, and hydrocodone, a previously unreported combination. Symptoms resolved with antipsychotics and cessation of offending drugs.[ncbi.nlm.nih.gov]
  • We present a case of a 2-year-old child who developed hyperirritability, psychosis, and ataxia after being overmedicated with a pseudoephedrine/dextromethorphan combination cough preparation, and discuss probable mechanisms of toxicity and risk factors[ncbi.nlm.nih.gov]
Developmental Disabilities
  • This and other published cases suggest the existence of a distinct organic mental syndrome in developmentally disabled persons which responds to drugs that increase indoleaminergic activity.[ncbi.nlm.nih.gov]
Bilateral Flank Pain
  • We describe the case of a 22-year-old male who developed severe bilateral flank pain, hematuria, and oliguria after an isolated recreational ingestion of guaifenesin and dextromethorphan.[ncbi.nlm.nih.gov]
Uremia
  • As the patient's dialysis schedule was adequate, these symptoms were likely not due to uremia.[ncbi.nlm.nih.gov]
Extrapyramidal Symptoms
  • A moderate ingestion of dextromethorphan in a toddler resulted in extrapyramidal symptoms with opisthotonus that responded to diphenhydramine.[ncbi.nlm.nih.gov]
Opisthotonus
  • The child was given diphenhydramine with clearing of her opisthotonus but persistence of her ataxia and nystagmus.[ncbi.nlm.nih.gov]

Workup

  • She was scheduled for a cardiac syncope workup, but never followed through. Two months later, she presented to the hospital again for a similar complaint. Coworkers reported witnessing sudden tonic-clonic movements and confusion.[ncbi.nlm.nih.gov]
Epileptiform Activity
  • Although sodium benzoate normalized serum glycine levels (103 to 125 mumol/L), cerebrospinal fluid glycine levels remained elevated (42 to 47 mumol/L), with epileptiform activity on electroencephalography.[ncbi.nlm.nih.gov]

Treatment

  • Outcome was measured on the basis of patient self-report, treatment team evaluation, and physical examination by psychiatrists and primary care physicians.[ncbi.nlm.nih.gov]
  • No changes were made to the pre-existing drug regimen during the course of treatment with DMQ. The primary outcome measure was the Clinical Global Impression-Improvement (CGI-I) score after 90 days of treatment.[ncbi.nlm.nih.gov]
  • Long-term Risp treatment attenuated inflammation and potentiated the neurotrophic function but also produced a certain degree of toxicity. Risp DM was more beneficial and less toxic than Risp-only treatment.[ncbi.nlm.nih.gov]
  • To evaluate the role of dextromethorphan/quinidine (DM/Q; Nuedexta ) in the treatment of pseudobulbar affect (PBA).[ncbi.nlm.nih.gov]
  • The patients at BP goal after each treatment period were defined as the responders and kept on the same combination till the end of the study. The responder rate of each treatment period was recorded.[ncbi.nlm.nih.gov]

Prognosis

  • Nonketotic hyperglycinemia (NKH) is an inborn error of glycine degradation causing muscular hypotonia, seizures, apnea, and lethargy; it has a poor prognosis.[ncbi.nlm.nih.gov]

Etiology

  • Possible medical and psychiatric etiologies related to this brief psychotic episode in a geriatric patient are also discussed.[ncbi.nlm.nih.gov]
  • Increasing evidence suggests that inflammation contributes to the etiology and progression of schizophrenia.[ncbi.nlm.nih.gov]

Epidemiology

  • This was supplemented by references gleaned from recent epidemiological surveys and credible online sources to ensure most up to date information is gathered.[ncbi.nlm.nih.gov]
  • This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem[ncbi.nlm.nih.gov]
  • Human surveillance data and retrospective studies have shown dextromethorphan to be relatively safe during the first trimester; a human epidemiologic study and a smaller controlled study have not demonstrated elevated risks of congenital malformations[pdr.net]
Sex distribution
Age distribution

Pathophysiology

  • If DXM reduces FM pain, it will provide important information about the nature of FM pathophysiology. Fibromyalgia (FM) is a chronic, widespread pain syndrome.[clinicaltrials.gov]

Prevention

  • Today, StopMedicineAbuse.org is a hub of prevention-related information and a host of free resources.[chpa.org]
  • Use proper storage and disposal, to help prevent abuse. Take action by having frequent conversations with the teens and young adults in your life about the dangers of medicine abuse. Learn how.[medicineabuseproject.org]
  • CHPA supports the DXM Abuse Prevention Act of 2015 (H.R. 3250) introduced into the U.S. House of Representatives by U.S. Reps. Bill Johnson (R-OH) and Doris Matsui (D-CA).[chpa.org]
  • Because dextromethorphan is misused primarily by younger adolescents, the early identification and treatment of dextromethorphan abuse may be important in preventing broader substance abuse in these children.[ncbi.nlm.nih.gov]
  • The combination regimen of dextromethorphan and cyclosporine A could be effective for the treatment and prevention of acute encephalopathy with biphasic seizures and late reduced diffusion.[ncbi.nlm.nih.gov]

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